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Reproductive Physiology, Endocrinology, and Infertility

Question
37 out of 56
 

A 20-year-old female presents with excess facial hair and oligomenorrhea, increased levels of free testosterone, and normal ovaries on USG. Most likely diagnosis is: (AIIMS, May 2012)



A PCOD

B Adrenal hyperplasia

C Idiopathic hirsuitism

D Testotosterone secreting tumor


Ans. A

PCOD

Explanation:

1. Criteria for diagnosis of PCOS/PCOD:

2. At least 2 of 3 should be present:

a. Oligo/anovulation (causes oligomenorrhea, amenorrhea, and infertility)

b. Hyperandrogenism: Biochemical or clinical (increased serum androgens or acne, hirsuitism)

c. 12 or more than 12 follicle 2–9 mm in size present within 1 or both ovaries

3. on USG and/or ovarian volume > 10 mL (necklace-of-pearl pattern).

4. As the patient in the question satisfi es fi rst 2 criteria, she is a case of PCOS.

5. In PCOS, USG shows a necklace-of-pearl pattern in 50–75% cases only.

6. Ovaries can be normal on USG in a case of PCOS.

7. Normal ovary rules out androgen-producing tumor, and elevated testosterone rules out idiopathic hirsutism.

8. Congental adrenal hyperplasia (CAH) will generally manifest at birth with ambigious genitalia and clitoromegaly, and they also generally have primary amenorrheA. Also, virilization will be seen in patients of CAH.

Reproductive Physiology, Endocrinology, and Infertility Flashcard List

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